Early warnings signs of dementia and Alzheimer's disease

If you could take a test and find out that you are going to develop Alzheimer's disease, would you want to know? Would your opinion change if the test were only 90% effective? This is a choice that people may have the ability to make in the not too distant future, based on recent research from Georgetown University.

The research team has developed a blood test that analyzes ten specific lipids in the bloodstream to assess early warnings signs of dementia and Alzheimer's disease. These lipids undergo changes as part of the breakdown process of brain cell membranes, and thus may serve as useful markers for the onset of dementia.

The lipid connection was produced from samples of blood taken from over 500 volunteers aged 70 and older. These patients were observed over a five-year period for signs of developing dementia, and the earliest observations of dementia yielded the ten test lipids as potential markers.

With this observation, researchers tested the remaining volunteers for correlations over time between the lipid markers and the development of dementia or Alzheimer's. The results were that in 90% of the cases, the lipid markers correctly assessed the future state of the patient within a two or three year timeframe. A summary of this work was published recently in Nature Medicine.

The goal of the research team is to validate the lipid test over a larger population, and eventually offer this test commercially. The goal is not completely related to money-the team believes that research for a cure can be advanced if a population is identified that would be ready and willing to consider clinical trials of experimental therapies. If the disease has progressed beyond a certain point, intervention may be futile. Analogous to cancer treatments, the sooner Alzheimer's or dementia is detected, the more likely it is that an effective treatment can be found.

A test of this nature would need to mimic cancer treatments in another way-it would be important to set up counseling so that people can understand the risks involved and how to cope with the potential results they may get. It is also very important that people be presented with the choice of whether to take the test or not.

Quite a number of ethical concerns and other practical issues would have to be dealt with before this test could be commercially offered. For example, what are the insurance implications? An insurance company would be unlikely to be able to mandate such a test, but if you choose to take it, do they have a right to know the results? Would an insurance company have the right to alter your coverage based on your new assessment of risk?

Alzheimer's is a devastating disease, and anything that can truly advance a cure is a worthwhile development. Hopefully, the lipid test is refined and can indeed be used to expedite a cure-but it remains extremely important that individuals have the choice of participating in the test, or letting nature take it's course, so to speak.